The aim of the present study was to investigate whether patients with rhinitis medicamentosa who stopped using the topical vasoconstrictors may use these drugs again more than 1 year later. Eight patients received oxymetazoline nasal spray containing benzalkonium chloride 3 times daily for 7 days, 13–19 months after they had stopped using nasal decongestant sprays containing benzalkonium chloride. Before starting the course of treatment and after its conclusion, recordings of the mucosal surface positions were made with rhinostereometry, followed by histamine challenge tests. Symptoms of nasal stuffiness were estimated on visual analogue scales (0–100). After 7 days, nasal stuffiness, estimated by symptom scores and measurements of nasal mucosa swelling, was found, as well as an increased histamine sensitivity, which was interpreted as a sign of nasal hyperreactivity. In conclusion, patients with rhinitis medicamentosa who overuse topical decongestants and are able to stop using such drugs should be careful about taking these drugs again, even for a few days. They must be informed about the fast onset of rebound congestion upon repeated use in order to avoid the return of the vicious circle of nose drop abuse.

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